2021-2022 Hannaford Career Center Program Application Form
Students (with the support of parents/guardians) should complete this form to enroll in technical and pre-technical programs at the Hannaford Career Center. Please make sure all information is accurate and complete. We use the demographic information to communicate news and announcements through both email and regular mail. We look forward to reviewing your application. Thank you.
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Student Name *
High School *
School Grade in 2021-2022 *
Date of Birth *
MM
/
DD
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YYYY
Gender Identity *
Street Address *
Town *
Zip Code *
Town of Residence *
Household Telephone Number *
Student Cell Phone Number *
Student Preferred Email *
Parent/Guardian #1 Name *
Parent/Guardian #1 Home Phone *
Parent/Guardian #1 Cell Phone *
Parent/Guardian #1 Street Address *
Parent/Guardian #1 Town *
Parent/Guardian #1 Zip Code *
Parent/Guardian #1 Email Address *
Parent/Guardian #1 Place of Work *
Parent/Guardian #1 Place of Work Phone Number *
Parent/Guardian #2 Name
Parent/Guardian #2 Home Phone
Parent/Guardian #2 Cell Phone
Parent/Guardian #2 Street Address
Parent/Guardian #2 Town
Parent/Guardian #2 Zip Code
Parent/Guardian #2 Email Address
Parent/Guardian #2 Place of Work
Parent/Guardian #2 Place of Work Phone Number
Emergency Contact Name (Other than Parent/Guardian) *
Emergency Contact Phone Number *
Emergency Contact Relationship to Student *
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